Taha Scoli
-
Upload
neareastspine -
Category
Documents
-
view
242 -
download
0
Transcript of Taha Scoli
-
8/7/2019 Taha Scoli
1/48
Lateral Interbody Fusion (DLIF)
in patients with De-Novo Adult
Degenerative Scoliosis Associate Professor of Neurosurgery
Advanced Neurosurgery, Inc
Dayton, OhioInterest: Minimal Invasive Spine
surgery
Jamal Taha, MD
-
8/7/2019 Taha Scoli
2/48
Lateral Interbody Fusion (DLIF) in
Patients with De-Novo AdultDegenerative Scoliosis
J. Taha, MDNeurosurgery
Kettering Medical NetworkDayton, Ohio USA
Dr. Taha is a consultant for Medtronic
-
8/7/2019 Taha Scoli
3/48
What is Direct Lateral?
Variation of retroperitonealapproach that is minimallyinvasive
Muscle-splitting TransPsoasapproach
Considered closely similar toanterior approach
Best suited for L1-L5, can bedone in thoracic
-
8/7/2019 Taha Scoli
4/48
-
8/7/2019 Taha Scoli
5/48
Surgical Procedure
-
8/7/2019 Taha Scoli
6/48
-
8/7/2019 Taha Scoli
7/48
APPROACH
Obl. Ext M
Obl. Int M
TransversusM.V.Cave
Aorta
Surgical Procedure
-
8/7/2019 Taha Scoli
8/48
-
8/7/2019 Taha Scoli
9/48
Surgical Procedure
-
8/7/2019 Taha Scoli
10/48
Distraction
-
8/7/2019 Taha Scoli
11/48
Distraction
-
8/7/2019 Taha Scoli
12/48
-
8/7/2019 Taha Scoli
13/48
DLIF in Deg Scoliosis
DLIF is emerging as a viable alternativeto Posterior or Posterior/Anteriorsurgery that is minimally invasive with
less complication rate Can be utilized as a primary correcting
tool for scoliosis or as a secondarystabilizing tool for scoliotic spine
undergoing surgery
-
8/7/2019 Taha Scoli
14/48
Role of DLIF in Scoliosis Surgery
Advantages* Ant column structural stability
disc height & maintainsdistraction between end plates
regional sagittal & coronalbalance
Indirect neural decompression
Good support for hardware endvertebrae
fusion rate (osteoporosis Anterior release
Unloads facet joints
stress on posterior hardware
? Shorter level instrumentation
Disadvantages Technically more tricky
Rotation Vertebrae
Rotation L-S Plexus
? Inferior to osteotomy inFixed & Rigid Curves.Role may be best forflexible curves and mayhelp in changing PSO toPont osteotomy
*J Neurosurg Spine 7, 2007
-
8/7/2019 Taha Scoli
15/48
Lateral TransPsoas in Deg Scoliosis
Cobb AVT Lordosis VAS ODI
Anand et al* 227 73 5539
Tormenti et al* 38.510 3.61.8 47.340.4 8.83.5
Dakwar et al* 8.12.4 5329
Wang et al* 31.411.5 37.445.5
Diaz et al+ 188 3441 9.13.2 4919
Patel et al++ 20.211.7
* Neurosurg Focus 28 (3), 2010
++ Superior results to PLIF/TLIF controlled cohort for Cobb angle & AVT
All had blood loss 50-500 ml, less than open surgery (average=2.11 Lit**)
Comparable results for VAS to open surgery (Spinal Deformity Study Group)
** Cho et al: Spine 32, 2007
+ Diaz et al: Spine 2006
++ Patel et al: Spine 2009
-
8/7/2019 Taha Scoli
16/48
Case RoBack & Leg Pain
-
8/7/2019 Taha Scoli
17/48
-
8/7/2019 Taha Scoli
18/48
Case Ro: Back & Leg Pain
L4-L5
-
8/7/2019 Taha Scoli
19/48
Case Ro: Back & Leg Pain
32
9
-
8/7/2019 Taha Scoli
20/48
Case RoBack & Leg Pain
-
8/7/2019 Taha Scoli
21/48
Case DG: Back & Leg Pain
-
8/7/2019 Taha Scoli
22/48
Case DGBack & Leg Pain
-
8/7/2019 Taha Scoli
23/48
Case DG: Back & Leg Pain
-
8/7/2019 Taha Scoli
24/48
Case DG
30
45
Back & Leg Pain
-
8/7/2019 Taha Scoli
25/48
Case DGBack & Leg Pain
-
8/7/2019 Taha Scoli
26/48
Case JB
1 yr
Back Pain
-
8/7/2019 Taha Scoli
27/48
Case JB: Back Pain
-
8/7/2019 Taha Scoli
28/48
-
8/7/2019 Taha Scoli
29/48
Case JB
25
40
Back Pain
-
8/7/2019 Taha Scoli
30/48
Case LWBack Pain
-
8/7/2019 Taha Scoli
31/48
Case LW: Back Pain
-
8/7/2019 Taha Scoli
32/48
Case LW: Back Pain
-
8/7/2019 Taha Scoli
33/48
Case LW: Back Pain
-
8/7/2019 Taha Scoli
34/48
Case LW: Back Pain
-
8/7/2019 Taha Scoli
35/48
Case LW
16
0
Back Pain
-
8/7/2019 Taha Scoli
36/48
Case LW
5055
Back Pain
-
8/7/2019 Taha Scoli
37/48
Case Bo: Back & Leg Pain
-
8/7/2019 Taha Scoli
38/48
Case Bo: Back & Leg Pain
-
8/7/2019 Taha Scoli
39/48
Case Bo
3210
Back & Leg Pain
-
8/7/2019 Taha Scoli
40/48
Case Bo
19 39
Back & Leg Pain
-
8/7/2019 Taha Scoli
41/48
Case Ha
Back Pain
-
8/7/2019 Taha Scoli
42/48
Case Ha: Back Pain
-
8/7/2019 Taha Scoli
43/48
-
8/7/2019 Taha Scoli
44/48
Case Ha: Back Pain
24
41
-
8/7/2019 Taha Scoli
45/48
Case Jo: Back Pain
-
8/7/2019 Taha Scoli
46/48
Case Jo: Back Pain
103
-
8/7/2019 Taha Scoli
47/48
Case No
-
8/7/2019 Taha Scoli
48/48